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M <br /> LAND USE PERMIT APPLICATION— Burnett County, WI g i-d� <br /> Applicant Complete All Sections Below This Line • <br /> 1O. <br /> Permit Types and Fees:(Please,check appropriate boxes) 4 <br /> - Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200E s <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 o <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150ii <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 p <br /> C, <br /> XDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 R <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o &) <br /> Filling/Grading $150 Boathouse $500 w <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 1 <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. Ik <br /> r =. <br /> 0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. Z <br /> P <br /> .71 <br /> NORTH CAMP PROPERTIES V, LLC ,r <br /> Property Owner's Name: 0. <br /> LT <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 <br /> City State Zip C 1 <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 0 ►r <br /> Contact's Telephone Number: 715-204-4043 d �, <br /> Contact's Email: rD <br /> kellee@northcampproperties.com 4-1 0 <br /> N 'b <br /> o or? <br /> C <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 5 <br /> C <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND ti <br /> n' <br /> *Attach additional page if(needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> v) <br /> Tax ID#(1-5 digit number:; found on tax statement): 35424 H -- <br /> Proposed Use of Structure/Addition: N '' 5 <br /> Anticipated Start Date: (Home/C'ahin;Commercial Business,.Bedroom,Deck;etc.) '-3 I W <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z k , <br /> r . <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions, manufactured homes, manufactured <br /> home additions,and bunkliouses.** <br /> mt - ail Si c / <br /> v4 �I 1 ;A 7Je 4E1 jt, re ve _, FeeRec: 7'19.5-c <br /> i&az"bo <br /> n Check#: /G�l0 3/ <br /> 4kT <br /> Date of staff site visit: qi?-1 /P-3 Initials o site visits 'f: nt <br /> u <br /> a <br /> C� <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: `A5/3.3 0 �^—=-� <br /> t 151 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF CO gri) <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT C <br /> fill <br /> iE rs,a c==* <br /> Page 1 of 5 ff,r <br /> Burnett County, WI Land Use Application—Rev 05/2022L` JJ: <br /> 0 <br /> a ' <br />